Effects of Carbonated Thickened Drinks on Pharyngeal Swallowing with a Flexible Endoscopic Evaluation of Swallowing in Older Patients with Oropharyngeal Dysphagia

Abstract

This study aimed to determine the efficacy of carbonated and sweetened drinks added to thickened liquids, which are routinely used for patients with dysphagia to improve dysphagia. Patients swallowed thin liquid (Thin), thickened liquid (Thick), carbonated thin drink (C-Thin), and carbonated thickened drink (C-Thick) in random order. Penetration and/or aspiration were scored using the Penetration–Aspiration Scale (PAS). The residue was scored using the Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS). Swallowing reflex initiation was scored using the Hyodo score. The subjective difficulty of swallowing was scored on a face scale. We analyzed 13 patients with a mean age of 79.6 ± 9.6 years. PAS was significantly lower in the C-Thick group than the Thin group (p < 0.05). Swallowing reflex initiation was significantly different between the Thin and Thick (p < 0.01) groups; moreover, post hoc analysis revealed that it was significantly lower in the C-Thick group than the Thin group (p < 0.01). The subjective difficulty of swallowing in the C-Thick was significantly lower than the Thick group (p < 0.05). C-Thick was easier to swallow than Thick and may improve penetration and/or aspiration in older patients with dysphagia with complex diseases.

Rheology for Safe Swallowing 3

“…Saiki et al 338) concluded that CTL cola was more beneficial for dysphagia patients than NTCL. Similar conclusions were reported [339][340][341] . CTL was reported to reduce the risk of aspiration even for dementia patients with Lewy bodies and Parkinson's disease 342) .…”

Effects of thickened carbonated cola in older patients with dysphagia

“…Carbonated liquids improve swallowing, which may prevent penetration and aspiration 16 . The effect of thickened carbonated beverages on swallowing dynamics has been verified in previous studies 17 . However, the effects of carbonation in commercially available thickened carbonated beverages have not been explored.…”

Are Bubbles the Future of Dysphagia Rehabilitation: A Systematic Review Analysing Evidence on the Use of Carbonated Liquids in Dysphagia Rehabilitation

“…Different studies administered different volumes of CTL to participants, i.e., Bulow et al [ 13 ] used 5 mL sips, Sdvarou et al [ 11 ] used incrementing volumes up to 25 mL, whereas Turkington et al [ 15 ] and Morishita et al [ 10 ] did not use measured volumes but participants were required to take discrete non-measured sips on demand, or as much as they could in one mouthful. The VF assessment also varied between studies with Sdravou et al [ 11 ], Bulow et al [ 12 ] and Turkington et al [ 15 ] using 25 frames/s, Jennings et al [ 14 ] and not commenting on details of VF frame speed and Larsson et al [ 13 ] using a frame speed of only 16 frames/s which makes it possible that their results are less accurate by possibly missing some aspiration between frames.…”

“…Different studies administered different volumes of CTL to participants, i.e., Bulow et al [ 13 ] used 5 mL sips, Sdvarou et al [ 11 ] used incrementing volumes up to 25 mL, whereas Turkington et al [ 15 ] and Morishita et al [ 10 ] did not use measured volumes but participants were required to take discrete non-measured sips on demand, or as much as they could in one mouthful. The VF assessment also varied between studies with Sdravou et al [ 11 ], Bulow et al [ 12 ] and Turkington et al [ 15 ] using 25 frames/s, Jennings et al [ 14 ] and not commenting on details of VF frame speed and Larsson et al [ 13 ] using a frame speed of only 16 frames/s which makes it possible that their results are less accurate by possibly missing some aspiration between frames. Whilst the studies focused on participants with neurogenic dysphagia and dysphagia following surgery, participants had a range of neurological diagnoses across the studies which may have affected results, and some of the participants in the studies by Bulow et al [ 13 ] and Morishita et al [ 10 ] did not actually have any neurological impairment, with the most common aetiology of dysphagia in the study by Morishita et al [ 10 ] being deconditioning.…”